The magic angle effect: A source of artifact, determinant of image contrast, and technique for imaging

This review provides a formalism for understanding magic angle effects in clinical studies. It involves consideration of the fiber-to-field angle for linear structures such as tendons, ligaments, and peripheral nerves, disc-like and circular structures such as menisci and labra, as well as complex three-dimensional structures. There may be one or more fiber types with different orientations within each of these tissues. The orientation of these fibers to B-0 is crucial in determining their magic angle effect. Tissues may show a variety of appearances depending on their baseline T2, as well as the increase in T2 produced by the magic angle effect. The appearances are affected by TE, which affects both the general tissue signal level and the change in signal produced by the magic angle effect, fiber-to-slice orientation, and partial volume effects. Deliberate positioning of structures and tissues at particular orientations to B-0 can be used to increase the signal from tissues such as tendons and ligaments and so allow them to be imaged with conventional sequences. The technique can also be used to produce contrast between tissues with fibers that have different orientations to B-0.